Date 05/28/2017

Honorable Rex Tillerson,
Secretary of State,
State Department
2201 C-Street, N. W.
Washington, DC 20520

RE: Significant rise in the J1 visa refusals for Pakistani physicians

Dear Mr. Secretary,

We, the undersigned, physicians and members of APPNA (Association Of Physicians of Pakistani Descent of North America) would like to bring an issue of significant importance to your attention.

In the previous month of May 2017, there has been a significant rise in the refusal of J1 trainee visas to Pakistani physicians. These physicians have completed an exhaustive process of passing required qualifying exams, ECFMG (Education Commission on Foreign Medical Graduates) certification, the interview process for residency training, and the selection process for the USA Residency Program in an accredited training hospital. They were issued contracts by the respective hospitals and have also received the necessary paperwork from the ECFMG and the Pakistani Government for an Exchange Visa Program. The final step was to get a J1 visa from the US Embassy in Islamabad and US Consulate General in Karachi to proceed to the USA for training. Traditionally the residency-training year starts on July 1st of every year.

We know of at least twenty-six physicians who were turned down at the eleventh hour. There are probably many more. These are highly trained and educated young Pakistani professionals. They have not only attained a high degree of education benchmark in Pakistan but have also successfully completed the US requirements for a residency program. Additionally, these physicians are an important part of the US health care delivery system.

The reasons given to the visa applicants, through the information received by us, were varied. The most common reason for the refusal is to not have enough social ties for the individual to come back to Pakistan. It is to be noted that the J1 visa is issued specifically for the purpose of returning to the country of origin. All the applicants have to abide by the rules and there is not a single known case of a J1 visa holder who disappeared after the visa had expired.

We strongly believe that all the reasons given are trivial at best and give the impression of a concerted policy to deny visas to aspiring physicians from Pakistan. We believe that the policies are not enforced with the same level of strictness to physicians from countries other than Pakistan. As such they are discriminatory.

If this trend continues then it would put the professional future of these physicians at risk. It will deny Pakistan of the professionally trained physicians who have a commitment to go back and help the country in the time of need. It also creates a crisis situation for the affected US hospitals and the population they serve. The hospitals have to find a new trainee physician on an urgent basis, and if they are unable to find one, may have to put added burden on the existing training staff. Most importantly it will put the care of patients at these hospitals in serious jeopardy. These hospitals have selected these Pakistani Physicians for the training program for the sole reason that they were unable to get local physicians to fill in these residency slots. It will also deter the future training program directors to select physicians from Pakistan as they may again face similar denials of visas.

Pakistan's friendship to the USA in these difficult times is well known to you. Pakistan has been the frontline country in alliance with the USA, whether it was to defeat the Soviet aggression in Afghanistan or the present day the war on terrorism. This current tightening of the visa process will further put credence to the perception in Pakistani public that the US policies are not fair to Pakistan, let alone be favorable.

Pakistani-American physicians work very hard to uplift the profile of US in Pakistan. We feel that the deserving Pakistanis must benefit from the American training facilities, and become functional ambassadors for US-Pakistan relationship. It is our opinion that irritants such as unusually high rejection rate for trainee physicians at the US embassy in Islamabad would set these efforts back and is likely to create more foes than friends for us. While it is the US's privilege to offer any kind of visa to anyone, there must be justifiable and comparable grounds to reject people.

We request you to kindly take full and personal interest into identifying the reasons behind this obvious policy change and help resolve this gross mistake. We urge you to take immediate personal interest and impress on the US Embassy in Pakistan to deal with these visa applicants with due fairness and professionalism. We request that those who were denied the visas should be issued the required visas without further delay.

Sincerely,

Committee on Young Physicians (CYP)
Advocacy and Legislative Affairs Committee
Association Of Physicians of Pakistani Descent of North America